D2 Friday, 07.17.2015 The Daily Herald
Hospitals to seek more challenging patient mix T he Department of Defense will ask Congress for new authorities to funnel more challenging cases into military treatment facilities, a move aimed at sustaining wartime specialty skills and overall medical readiness, said Dr. Jonathan Woodson, assistant secretary of defense for health affairs. The effort to enrich the patient mix, particularly for inpatient care, will focus on treating more elderly patients, more veterans with complex conditions who might otherwise be ineligible for on-base care, and more military retirees who also are DoD civilian employees. Woodson and the surgeon generals of the Army, Navy and Air Force appeared before a House panel in June and largely rejected the sweeping reforms to military health care and the Tricare benefit recommended by the Military Compensation and Retirement Modernization Commission. But the commission’s report had Woodson and the uniformed medical leaders defending the effectiveness of military treatment facilities as wartime training platforms, and discussing new ways to attract a more demanding case mix and to expand the workloads of physicians at base hospitals. “There are going to be some new authorities we’ll need, to allow patients to flow from the market to the MTFs (military treatment facilities) to ensure we have the proper case mix,” Woodson told the House armed
TOM PHILPOTT MILITARY UPDATE services subcommittee on military personnel. “This is to include new ways of attracting Medicare-aged patients” and perhaps to “actually define a sort of Medicare Advantage within the MTFs. We (also) need to be given broader authorities that relate to taking care of veterans,” Woodson said. “There’s even an opportunity for us to take care of DoD civilians (because) we have a lot of dual-eligible folks who work for the federal government and they have Tricare benefits. So why not allow them to use their Tricare benefits within MTFs?” These steps, he said, “would lead to a proper utilization of the MTFs, proper market management (for) the case-mix, skill-mix issue” that worries commissioners, and “extraordinary service to the beneficiary population.” Asked when he will seek these authorities, Woodson told us recently that internal discussions to “optimize” use of MTFs continue. He said the DoD would work closely and transparently with Congress to give the military
health system “greater agility to shape the delivery of health care in today’s evolving and fast-moving market place.” However, any action taken to enhance case mix also would preserve “timely access to care for our existing beneficiaries and enrollees,” he said. As to which facilities would use new authorities to corral more challenging cases, Woodson said the service medical departments would decide that “based on specific readiness requirements, capabilities and capacity. All decisions will need to be tailored to the geographic locality of the MTF and what those local needs and requirements are.” The compensation reform commission had urged creation of a four-star Joint Readiness Command to be responsible for preserving medical readiness gains after 14 years of war. In arguing for the four-star command, commissioners cited data from the health system’s self-analysis during an ongoing modernization study that show many military physicians have light inpatient workloads compared to civilian peers and a mundane case mix when measured against what’s needed to stay ready for war. The commission’s other major health reform idea is to replace the triple-option Tricare benefit with Tricare Choice, a menu of private sector health insurance offerings for military families and retirees to pick their desired coverage. Premiums and
IN UNIFORM Active Duty Slava Ulanovskiy in May 2016 will start training that will make him one of the world’s elite pilots through the Euro-NATO Joint Jet Pilot Training Program at Sheppard Air Force Base in Wichita Falls, Texas. Ulanovskiy is one of 51 cadets, from 143 Air Force detachments nationwide, Slava selected for the ENJJPT Ulanovskiy program, according to Central Washington University, where he graduated in June. Ulanovskiy, whose given name is Vyacheslav, emigrated from Russia to the United States when he was 5 years old. He is a graduate of Monroe High School. He became a U.S. citizen while attending CWU. Following commencement on June 13, he was commissioned as a U.S. Air Force second lieutenant through the university’s Reserve Officer Training Corps program.
Veterans news Homeless, unemployed veterans can get help through Workforce Snohomish. Help includes employment assistance, support services, help with VA benefits and housing. Call Gordon Meade at 425-921-3478 or write to gordon.meade@workforcesnohomish. org. The Veterans of Foreign Wars posts and auxiliaries of Snohomish County are looking for new members. Needed is your last separation certification or other proof of eligibility. Auxiliary members are wives, widows, mothers, etc. For more information, call 425-337-1559.
Veterans calendar Disabled American Veterans, Martin T. Sofie Sunshine Chapter 13: 7 p.m. first Thursdays, Lynnwood Elks, 6620 196th St. SW. More info: 425-218-0034, don.whedon06@gmail.com. Fleet Reserve Association Branch 170: 5 p.m. second Wednesdays, 6802 Beverly Blvd., Everett. More info: 425-353-2600. The Military Order of the Purple Heart Chapter 12: 7 p.m. fourth Tuesdays, Lynnwood Elks Club, 6620 196th St. SW. More info: Dennis C. Adams, 206-280-0022. Coast Guard Auxiliary: 7 p.m. second Tuesdays, Port of Everett Conference Center, 404 14th St. More info: Marie Porterfield, 425-629-3241, 509-949-6715, Marie.Porterfield64@gmail.com. Fleet Reserve Association and Ladies Fleet Reserve Association Unit and Branch 18: Lunch noon, meeting 1 p.m. second Saturdays, 23003 56th Ave. W., Mountlake Terrace. More info: 425-771-2774. Veterans: An unaffiliated group of veterans of wars in foreign lands meets at 1 p.m. second Wednesdays, Carl Gipson Senior Center, 3025 Lombard Ave., Everett. More info: 425-257-8780.
American Legion Arlington Legion Post 76 and Auxiliary: Meetings and monthly Saturday breakfasts resume in September. Lounge is open daily at 115 N. Olympic Ave. More info: 360-435-2492. Arthur Kincaid Legion Post 58: 7 p.m. third
co-payments of mid-range plans would be covered for active duty families by a new monthly health allowance. Woodson and the surgeons general rejected the readiness command as unnecessary and Tricare Choice as potentially stressful for families and harmful to readiness. By forcing base hospitals to compete with civilian insurers for patients, they said, Tricare Choice could result in military doctors seeing even fewer patients, aggravating the readiness challenge. Greater choice through commercial insurance would leave military treatment facilities “at a significant disadvantage in attracting patients,” Rear Adm. C. Forrest Faison, Navy deputy surgeon general, told the House panel. The Army supports “increased choice” for beneficiaries,” said Lt. Gen. Patricia D. Horoho, Army surgeon general. But the Tricare Choice plan “would negatively impact readiness of our entire health care team and present financial challenges to both active duty families and retirees.” The surgeons general concurred with commissioners that the military health care system should set training and resource levels so as to preserve essential medical capabilities, or EMCs. But the list of EMCs should be more comprehensive than commission’s targeting of combat casualty clinicians and logistical capabilities. “Those EMCs must address the whole spectrum of health rather than focus solely on combat
trauma and surgical capabilities,” Horoho said. She noted that less than one of every five service members evacuated from Iraq or Afghanistan were wounded. Most had diseases or non-battle injuries. It is true clinical skills needed for wartime deployment “don’t always exactly match up with our day-to-day practices at home station,” conceded Lt. Gen. Mark A. Ediger, Air Force surgeon general. But the services have known that and have processes in place to track and to augment that experience through partnerships with VA and civilian trauma centers. The Air Force for example, for each of its medical specialties, defines the “case volume and mix and skills that translate into the deployed environment,” Ediger said. “Then we keep records and we track the extent to which we are able to meet those requirements and keep clinicians ready.” For this year at least, Congress opted not to adopt the commission’s major health reform recommendations. Rep. Tom MacArthur, R-New Jersey, is one lawmaker who said his opinion was changed by department testimony. “I started as an advocate for change,” MacArthur said as the hearing came to a close. “But sometimes the cure can be worse than the illness.” To comment, write Military Update, P.O. Box 231111, Centreville, VA, 20120 or email milupdate@aol.com or twitter: @ Military_Update.
VITAL STATISTICS Tuesdays, Odd Fellows Building, 610 Lewis St., Monroe. More info: Bob at 360-863-3544, www.americanlegionmonroe.org.
MARRIAGE LICENSES
Bothell Legion Post 127: 7 p.m. second Wednesdays, 21920 Highway 9. Service officer available to help with veterans issues. More info: Commander Burt Marsh, 206-999-3254.
Ramstead, Scott David and Mozingo, Patricia Jean Horton, Robert Eugene Jr and Gray, Janice Lee Hensel, Gary Lee Anthony and Hong, Nong Yi Queen, Nicole Danielle and Chase, Alan Wesley Jones, Russell Lewis and Mcclintock, Sharon Tiffany Lim, Samantha Miyuki and Kiriluk, Benjamin Bohdan Christensen, Cristal Lee and Rhodes, Sean Michael Weston Branson, Travis Daniel and Petterson, Brittani Ann Strickland, Denim, Ayn and Hoke-Reyes, Kaleionalani Patek, Alan George and Evans, Adele Catherine Bash, Lonnie Lee Jr and Linsley, Stacy Ann Johnson, Tyler Blair and Jiao, Yang Magness, Bradly Charles and Hofferbert, Amy Marie Woody, Jack Howard and Dotchin, Janet Lynn Domenico, Joseph Anthony and Papineau, Heather Rae Alshemary, Mohammed Bakher and Alwaeli, Zahra Karim Schlieman, Brian Scott and Johnson, Peggy Jo Brown, Michael Alan and Lantz, Brittany Jean Siekierski, Olivia Cherise and Olson, Jeremy James Khalil, Magdy Samir and Youssef, Marina Hany Muller, Taylor Michelle and Mcgregor, Aaron Peter Preuss, Michael Paul and Richards, Mindy Nicole Raney, Angela Kay and Bell, Jonathan William Daher, Abdallah Ghassan and Chaffee, Alycia Michelle Sampaga, Melissa Bermudez and Siv, Steven Saveth Homann, Cody Dean and Fox, Jamie Marie Johnson, Jesse James and Burrows, Kylie Jo Sainvillis, Frantzson and Mitchell, Tianna Marissa Lovelett-Childers, Natalie and Malliris, Kevin Andrew Burroughs, Sarah Allyson and Strawn, Matthew Dale Davidson, Jennifer Helene and Thomson, Jared Matthew Bretz, Karl Robert and Moore, Lindsey Allison Hardey, Ian Donald and Santi, Nicole Elizabeth Russell, Kendra Jean and Bjorn, Jay Alexander, Lampard, Ayla Brianne and Koch, Philip Nichols Gruber, Linnea Anneliese and Bertrand, Hanson Reed Jr Cesari, Anna Marie and Carter, Timothy James Wong, Tom Tsai and Vu, Kathy Tvyet Thu Stanley, Richard Allen Jr and Balbin, Maureen Absalon Ndayizeye, George and Ndayikeza, Angeline Halverson, Heather Lyn and Womeldorf, Daniel Jacob Fenney Judy Ann and Lines, Richard Earl Park, Richard G and Kim, Yoon Jung Whitbeck, Amanda Rose and Ruchman, Jaime Ricardo Jackson, Natasha Lindsay and Stone, Michael Clayton Sanneh, Binta Omar and Nix, Elson Elector Bollen, Nichole Ashley and Scotton, Brandon, Levante Aho, Dianne Elizabeth and Hauck, Paul John Mccoy, Matthew Robert and Miller, Jeanine Ann Lyon, Jacob Daniel and Hartman, Jameson Joann Winningham, Patsy Diane and White, Tracy Lynn Simonson, Shawn Lynn and Eyer, Jennifer Nicole
Earl Winehart Legion Post 96: 7 p.m. second Tuesdays, Legion Hall, 1201 First St., Snohomish. More info: 360-568-5340. Frank Freese Legion Post 66: 6 p.m. third Mondays, Post Hall, 117 S. Sixth St., Edmonds. Light meal served at 5:15 p.m. More info: Les, 206-546-6831. Frank H. Hancock Legion Post 92 and Auxiliary: 7 p.m. second Mondays, 26921 88th Ave. NW, Stanwood. Prime rib dinner, 4:30 p.m. third Fridays. Service office open 9 a.m.-3:30 p.m. Tuesdays, Wednesdays , Thursdays. More info: 360-629-8021. Lake Stevens Memorial Legion Post 181: 7 p.m. second and fourth Thursdays, Lake Stevens Community Center, 1812 124th Ave. NE. More info: Tom at 425-314-5865, Tony at 360-6313242, or Vern at 425-343-9637; info@post181. org; www.post181.org. Lynnwood Legion Post 37: 7 p.m. third Thursdays, Lynnwood Elks Club, 6620 196th St. SW. More info: 425-585-0279. Marysville Legion Post 178 and Auxiliary: 7 p.m. third Thursdays, Post Hall, Second Street and Cedar Avenue. Social hour at 6 p.m. Service officer hours are 12-4 p.m. fourth Mondays at the Post Hall. More info: 360-653-0155, legionpost178wa@gmail. com, americanlegion178wa.cfsites.org. S. Al Wilcox Legion Post 234: 7 p.m. second Mondays, Legion Hall, 22909 56th Ave. W. , Mountlake Terrace. More info: Frank Martinez, 425-697-4102. Sen. Henry M. Jackson Legion Post 6: 6 p.m. second Thursdays, Fleet Reserve Association Club, 6802 Beverly Blvd., Everett. More info: Marvin, 425-923-8172.
Veterans of Foreign Wars Arlington Boyer-Daniel VFW Post 1561: 7 p.m. first Tuesdays. More info: 425-232-8453, 360-435-6677 or vfw1561.org. Edmonds VFW Post 8870 and Ladies Auxiliary: 6 p.m. second Tuesdays, with a light supper at 5:15 p.m., Edmonds American Legion Hall, 117 Sixth Ave. S. More info: Fred at 206-940-7502, dennisvfw8870@gmail.com, www.vfw8870.org. Ladies Auxiliary meets at noon second Fridays at the Edmonds Senior Center, 220 Railroad Ave. Everett Old Guard VFW Post 2100: 6:30 p.m. third Tuesdays, 2711 Oakes Ave. More info: Don Wischmann, 425-760-9031, www.vfwpost2100. org. Gold Bar Martin-Osterholtz VFW Post 9417: 6 p.m. first Thursdays, 301 Third St. More info: Doug White, 425-870-7298. Ladies Auxiliary: 3 p.m. first Thursdays. More info: Arden King, 360-793-2786. Lynnwood VFW Post 1040: 7 p.m. first Thursdays, Alderwood Youth Club, 19619 24th Ave. W. More info: Frank, 425-697-4102. Ladies Auxiliary meets 7 p.m. same location. More info: Myra Rintamaki, 206-235-0348. Monroe VFW Post 7511: 7 p.m. second Thursdays, IOOF Hall, 610 Lewis St. More info: Ken, 425-315-3509. Oak Harbor Whitehead-Muzzall VFW Post 7392: 360-675-4048 or vfwpost7392.org. Snohomish Gay Jones VFW Post 921 and Auxiliary: 1 p.m. second Saturdays, Boys & Girls Club, 402 Second St. More info: 425-397-7111. Sultan VFW Post 2554 and Ladies Auxiliary: 7 p.m. second Thursdays, United Methodist Church, 211 Birch Ave. More info: 425-870-0235. To submit news for this column, contact reporter Melissa Slager: mslager@heraldnet.com.
Warren, Nathan Gregory and Fehr, Krista Corinne Halbmaier, Paula Marie and Kendig, Joseph Arthur Dappen, Paula Mary Ann and Noble, Joseph Neil Johnston, Annette Marie and Harper, Andrew Thomas Mauer, Mitchell John and Neblina-Hernandez, Melissa Serhiychuk, Iryna Ivannivna and Lytvynchuk, Stepan Stepanovich Quioc, Eric Deonoso and Reyes, Yashmeen Yoko Tuazon Pelham, Michael Dean and Terwilliger, Chandell, Lee Sandvig,, Tera Christine and Alvarez, Nicholas James Loch, Sharon Lynn and Morris, Jon Matthew Stimac, Kathleen Mary and Mclean, Mark Thomas Payne, Thomas Edward Ii and Biek, Yanique Anakay Tua, Lanai Fa’aalo and Silao, Peter Knox Pachek, Scot Jeffery and Reisdorff, Rachel Lynne Dance, Sarah Marie and Dennis, Christian James Quaife, Rachel Joy and Miles, Tyler James Anderson, Ryan Alan and Hawley, Melinda Jo Sanchez, Hamilton Alexay and Yuen, Xenica Si-Yin Hendrickson, Michelle Arlene and Beckwith, Tyler James Lee, Hue and Xiong, Xengyeng Stone, Jessica Dawn and Reindl, David Len Norman, Christie and Messinger, Peter Edward Blumenthal, Gabriel Samuel and Kodom, Saowaluk Allett, Robert Paul Jr and Jaquez, Regina Marie Khampaphanh, Richie Xay and Klongklaew, Nareerat Paiva, Dacruz Arthur and Wycough, Sarah Mae Gomez, Julio Cesar and Vaimauga, Havila Gilippin Walruff, Kenneth Tate and Boggio, Cassandra, Eve Townsend, Katherine Alaina and Santo, Roger Lee Allanson, Brett David and Mcquillan, Ashley Kathryn Hanson, Jeffrey Burke and Robb, Danelle Renee Havlina, Hillary Anne and Thoreson, Scott Patrick Dunn, James Campbell and Pedersen, Kirsten Ann Bintliff, Leonard Adam and Gerber, Kristen Lee Anderson, Veronica Lynn and Matz, Arvid Joachim Zapotitla, Hernandez, Jorge and Dias, Vejar Martha Faviola Kieffer, Cory David and Harvey, Rozana Larae Jenkins, Madison Jo and Jones, Seth Anthony Berg, Blake Riley and Cline, Shelby Aileen Dullum, Aimee Elisabeth and Pickette, Jared David Mcgee, James Bernard and Mestas, Jennifer Marie Axlen, Leann Marie and Spokus, James Joseph Alsted, Amanda, Kristine and Garcia, John Waschell, Jeffrey Aaron and Dodge, Taylor Mckensie Gresham, Jennifer Lynn and Neubauer, Shaun Wesley Olson, Amanda, Renee and Summers, David Glen Fisher, Ashley Jan and Griffith, Michael Andrew Madsen, Terran Neal and Mccright, Angelina Rose Kinyanjui, David Thiongo and Ngigi, Jane Wanjiku Hussey, Jonathan Michael and Macias, Jacqueline Zhikhor, Albina Vladimirovna and Funk, Raymond Yakovlevich Lafave, James Michael and Lundahl, Savanah Marie Bloom, Brett William and Algic, Amy
Salcedo, Todd Vincent and Silverman, Dana Weatherly Greenberg, Rose Belinda and Davis, Anthony Sebastian Mahar, Sean Anthony and Hassain, Lisa Rachelle Reeves, Stephen Charles and Leonard, Erin Eileen Love, Heather Ann and Wilkes, Scott Michael Pulyak, George Andrew and St,. pierre Jessie Lynn Huggins, Fred Leroy and Macnamara, Victoria Paige Bamouni, Kristi Marie and Ngige, Daniel Murathe Mcdaniel, Levi James and Berenshtein, Mira Mara Farnsworth, Jesse James and Mendoza, Maria Cecilia Ogoy Longstreet, Joseph Titus and Hume, Jennifer Elizabeth Casana, Rolando, Luciano and Rodriguez, Yulia Bondoc, Elaine-Jessica Liam and Lai, Steven J Wagner, Tyler Andrew and Johnson, Aisha Marie Reed, Caleb Matthew and Prokopovich, Katrina Fitch Martin, Kim Lee and Lowe, Amber Dia Ashby, Amy Rebecca and Zimmerman, Gregory Winford Corson, Justin David and Donahoe, Anna Marie Spayth, Darrel Arthur Iii and Schlichemeyer, Brandy, Marie Arceo, Angela Marie and Quinn, Randall, John Wuollet, Sean Charles and Stewart, Amanda, Joy Eppig, Chad Joseph and Oster, Dakota Lorene Amin, Pedram and Wilson, Alicia Marie Siegel, Beau Windfield and Grater, Ashley Marie Dessel, Justin Henry and Lundin, Katie Denise Mirabal, Jean Marie and Mack, Linda May Mitchell, Kenneth Orlin and Martin, Deborah Ann Castro, Martinez Ivonne and Granados-Bonilla, Keldy Phillips, Jason James and Ferguson, Megan Elizabeth Henkel, Anna Christine and Dial, Jon James Valdivia, Jaime Oscar and Aldude, Choque Veronica Hancock, Danielle Marie and Steenberg, Andrew Michael Roberts, James David and Davis, Bonnie Nel Duvall, Zoe Noelle and Squires, Aaron Mark Wright, Janita Tenelle and Wright, Andrea Leigh Martin, Jessica Ann and Shroyer, Michael Todd Ushler, Aaron Guy and Passmore, Julia Ann Marie Leon, Thomas Craig and Brink, Kendra Leeanne Peterson, David Mark and Bayes, Deana Elizabeth Alloway, Lindsey Nicole and Baanrud, Jacob Thomas Allan Handy,, Christopher Robert and Brown, Heide Lean Brown, Spencer Curtis and Clark, Christianna Brooke
DEATHS Arnold, Norman, 83, Everett, July 2 Baker, Louise, 81, Brier, July 4 Bibb, Robert, 92, Everett, July 1 Bredstrand, Joseph, 73, Monroe, July 4 Burfitt, Beulah, 86, Lake Stevens, July 2 Cardinal, Emma, 86, Marysville, July 6 Carnes, Alan, 83, Snohomish, June 29 Carr, Lorraine, 87, Marysville, July 6 Cory, Donald, 60, Marysville, July 1 Cosby, Wade, 54, Marysville, July 3 Currie, Larry, 61, Everett, July 6 Dahl, Barbara, 91, Monroe,
July 1 Decker, John, 73, Marysville, July 3 Drager, Orville, 93, Bothell, July 7 Dunakoskie, Shirley, 72, Lynnwood, July 3 Escott, Charlotte, 97, Lake Stevens, July 1 Fenning, Lucille, 89, Lynnwood, July 5 Fischer, Donna, 84, Everett, June 30 Fisher, Harrison, 21, Kenmore, June 29 Gerber, Clara, 103, Monroe, July 7 Gipaya, Elmer, 74, Stanwood, July 6 Goodrich, John, 64, Marysville, July 4 Hammond, Bruce, 58, Mtlake Terrace, June 28 Hansen, John, 91, Stanwood, July 5 Hayes, Sharon, 69, Snohomish, July 3 Hayman, Shirley, 80, Everett, June 27 Jacobsen, Shirley, 83, Marysville, July 3 Jacobson, Clayton, 87, Marysville, June 30 Karder, Robert, 73, Seattle, June 8 Kelly, Mildred, 87, Everett, June 29 Kensinger, Stephanie, 22, unknown, June 23 Ketchum, Michael, 49, Arlington, July 4 Konsmo, Irene, 89, Everett, June 19 Kron, Evelyn, 83, Everett, July 6 Larrigan, Blandina, 103, Mukilteo, July 2 Leigh, Judith, 72, Everett, June 25 Leung, Chit, 68, Snohomish, June 25 Lewis, Lana, 47, Marysville, June 26 Loftis, Charles, 81, Everett, July 2 Mairs, Frances, 88, Lynnwood, July 3 Marino, Wendall, 79, Everett, June 30 Maynard, Samantha, 23, Snohomish, June 27 McCloskey, Catherine, 66, Tulalip, June 28 McKinney Jones, Leonard 78, Snohomish, June 30 Meier, Anna, 90, Everett, July 4 Morris, Nancy, 83, Bothell, July 1 Nelson, Lillian, 95, Lynnwood, July 4 Nelson, Naveah, 2 mos, Lynnwood, May 29 Noah, James, 93, Everett, July 3 Noland, Robert, 62, Tulalip, June 29 O’Neill, Sr, Leslie, 78, Arlington, July 2 Overdorf, III, William, 81, Lake Stevens, June 29 Overturf, Mary, 88, Langley, July 2 Parsons, Dennis, 80, Lake Stevens, July 5 Pearson, James, 77, Marysville, June 28 Phillips, David, 56, Everett, June 27 Pierce-Wallace, Vicki, 65, Marysville, June 27 Pleasant, Larene, 97, Lynnwood, June 29 Rose, Jean, 90, Everett, July 6 Sande, Leong, 96, Stanwood, July 1 Sasouvong, Khamphanh, 78, Mtlake Terrace, July 1 Schmaltz, Eugene, 83, Everett, July 7 Schmidt, Robert, 89, Everett, June 24 Sese, Ua, 62, Snohomish, June 20 Settle, Harry, 86, Everett, June 19 Shippam, William, 88, Lake Stevens, June 28 Shpreyregin, Boris, 91, Mtlake
See VITALS, Page D2